目的 探讨TCD联合CTA及CT灌注 成像在评估颈动脉狭窄或闭塞患者脑血流 动力学变化中的价值。方法 选取2013年4 月至2015年10月94例颈动脉狭窄或闭塞患 者为研究对象，选取同期在我院进行体检 的健康志愿者94例为对照组，所有患者及 志愿者均采用TCD联合CTA及CT灌注成像， 比较不同狭窄程度患者与对照组的脑血流 动力学变化情况。结果 轻度狭窄、中度 狭窄、重度狭窄、闭塞患者的两侧大脑 动脉平均血流速度分别为(61.09±18.37) cm/s、(55.26±18.61)cm/s、 (47.28±15.96)cm/s、(41.75±16.22） cm/s 显著低于对照组的(69.42±21.55) cm/s(P＜0.05)。轻度狭窄、中度狭 窄、重度狭窄、闭塞患者的达峰时间分 别为(8.24±2.39)s、(9.36±2.54)s、 (10.17±2.92)s、(10.94±2.75)s显著高 于对照组的(7.63±2.12)s(P＜0.05)。结 论 颈内动脉狭窄或闭塞与颅内动脉血流 动力学、侧支循环管开放情况、脑灌注参 数等密切相关，TCD联合CTA及CT灌注成像 可以综合评估颈动脉狭窄或闭塞患者的脑 血流动力学变化，为制定合理有效的治疗 方案提供科学依据。

Objective To explore value of TCD combined with CTA and CT perfusion imaging in the evaluation of changes of cerebral hemodynamics in patients with carotid artery stenosis or occlusion. Methods 94 patients with carotid artery stenosis or occlusion from April 2013 to October 2015 were selected as the research objects, 94 healthy examinees in our hospital in the same period were selected as the control group, all patients and volunteers underwent TCD combined with CTA and CT perfusion imaging, changes of cerebral hemodynamics of patients in different stenosis degree and the control group. Results Mean blood flow velocity of bilateral arteriae cerebri in patients with mild stenosis, moderate stenosis, severe stenosis and occlusion were (61.09±18.37)cm/ s, (55.26±18.61)cm/s, (47.28±15.96)cm/s, (41.75±16.22)cm/s respectively, which were significantly lower than the control group (69.42±21.55)cm/s (P<0.05). Peak time in patients with mild stenosis, moderate stenosis, severe stenosis and occlusion were (8.24±2.39)s, (9.36±2.54)s, (10.17±2.92)s, (10.94±2.75)s respectively, which were significantly higher than the control group (7.63±2.12)s (P<0.05). Conclusion Carotid artery stenosis or occlusion is closely related to intracranial arterial hemodynamics, opening situation of collateral circulation tube, cerebral perfusion parameters and others, TCD combined with CTA and CT perfusion imaging can comprehensively evaluate changes of cerebral hemodynamics in patients with carotid artery stenosis or occlusion, and provide scientific basis for formulating reasonable and effective treatment plans.